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General NPI Number Information
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NPI Number | 1689848939
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Entity Type | Individual
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Provider Name | VALENCIA ANQUENETTE GREEN L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 14502 W MEEKER BLVD
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5282
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Country | US
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Telephone | 602-703-6798
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Fax | 623-245-3176
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Provider Business Mailing Address
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Address Line | 12510 W HEARN RD
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City | EL MIRAGE
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State | AZ
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Zip | 85335-5919
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Country | US
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Telephone | 602-703-6809
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Fax | 623-245-3176
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 04555P
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License Number State | AZ
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